AN11--Automated Intervention System for Android - BOSTON

Summary: This is a Sources Sought notice and not a request for quotes. This request is solely for the purpose of conducting market research to enhance VHA s understanding of the market s offered products, services and capabilities. The Government will not pay any costs for responses submitted in response to this Sources Sought. This Sources Sought notice provides an opportunity for respondents to submit their notice of ability, and their available products and services in response to the requirement described below. Vendors are being invited to submit information relative to their potential of fulfilling the requirement below, in the form of a capability response that addresses the specific requirement identified in this Sources Sought. - The Veterans Health Administration (VHA) is seeking a vendor to provide the following products and/or services below. This Sources Sought is to facilitate the Contracting Officer s review of the market base, for acquisition planning, size determination, and procurement strategy. The Department of Veterans Affairs, Pittsburgh VA Medical Center, is in need of Two android applications, physical exercise intervention and cognitive exercise intervention, for an android smartphone. The target smartphone is the Samsung Galaxy On5 (T-Mobile version). The new modules needed for this new research initiative will be built on the existing Android platform and tie in with the current system design being used in existing telemedicine applications. The contractor will work directly with government personnel on the design and development of the android applications. Technical Specifications Salient Characteristics Two android applications: Essential/significant physical, functional, or performance characteristics: - Participants in the research program will be assigned to receive (1) physical exercise intervention alone, (2) cognitive exercise intervention alone, or (3) both physical exercise and cognitive exercise in combination. 1. Physical exercise intervention requirements The physical exercise intervention (i.e., bike program) will consist of a 5-minute warm-up phase, a 39-minute interval training phase, and a 5-minute cool-down phase with the bike set to the lowest resistance level for the entire session. All signals from the stationary bike will be checked at startup to ensure proper connections. If problems are detected, troubleshooting will occur. The application will check the signal from the stationary bike to ensure that the resistance level is set to the lowest level. If it is not, then the application will instruct the user to change it to the lowest level before starting the session. All session parameters (e.g., HR targets, length & number of intensity periods, timeouts) will be designed to be modifiable and loaded in at run-time so that changes can be made to these parameters without needing to change the code. A filtering and smoothing function for HR will be required to detect and prevent inaccurate signals from misrepresenting the actual HR used to determine exercise intensity. This function will continuously monitor HR to determine the fidelity of the HR signal. Outlier values will need to be filtered out to create a stable and accurate HR to assess the user s intensity during exercise. The interval training phase alternates between 4-minute high-intensity periods and 3-minute low-intensity periods for a total of 39 minutes. There will be six total high-intensity periods and five total low-intensity periods. The number and length of these intensity levels need to be modifiable parameters that are loaded at run time. During the high-intensity periods, there will be a target minimum HR based on a percentage of HRmax (220 user s age). The target HR will increase over time (Table 1). Table 1. Session Schedule for Increasing Target Intensity over 3 Months. Week Exercise Frequency (sessions/week) Target Minimum Exercise Intensity (% of HRmax [220-age]) 1-3 3 65% 4-6 3 70% 7-9 3 75% 10-12 3 80% If the user s heart rate is below the target, the application will prompt the user at specified intervals (default 30 seconds) to try to increase pedaling speed. If the user s heart rate is at or above the target, the application will prompt the user to continue at the current pedaling speed. For the target HR to increase to the next level, the user must reach the target during at least one high-intensity period for at least 2 weekly sessions during 3 consecutive weeks. These parameters will be modifiable to be loaded at run time so that they can be changed if needed. During the low-intensity periods, the user will be instructed to pedal slowly (<60% of HRmax). If the user has been assigned to receive both physical exercise and cognitive exercise in combination, the cognitive exercises will be delivered during warm-up period and these five low-intensity periods (see cognitive exercise application below). The application will have a stop session function so that the user can end a session early if needed. The application will have a pause function so that the user can take a rest and stop pedaling if needed. When pause is selected, a specified countdown (default =1 minute) will begin. A resume option will be displayed on the smartphone so that the user may resume before the rest period is done. If the user stops pedaling (i.e., speed = 0) during a session without using pause, the application will instruct the user to start pedaling again at specified intervals (default 30 seconds) until pedaling resumes. User heart rate and pedaling speed along with a timestamp will be saved at specified intervals (default =10 seconds) during each session. If the heart rate signal is lost during a session, the application will prompt the user to check the heart rate strap. Each week, there will be a goal of completing three sessions. These sessions will be scheduled in advance by the user. The application will alert the user when these scheduled sessions are due (see scheduling and reminder module below). Since users may not be able to complete full sessions or reach target HRs, the application will be programmed to dynamically compensate for this by encouraging the user to add more sessions to the weekly schedule. At the conclusion of each session, the system will review all of the sessions performed thus far for the week and those scheduled for the remainder of the week to determine if the participant should be encouraged to schedule any extra sessions. If any session during the week is less than 49 minutes or the user is unable to reach the HR target during any high-intensity periods, the user will be prompted to add 1 extra session during the current week or to the following week. All of these parameters will be modifiable to be loaded at run-time. At the conclusion of each session, during the final 5-minute cooldown, counseling will be delivered to the user (see counseling module below). Cognitive Session requirements For the cognitive exercise intervention, there will be a total of 38 different games for the user to play over the course of the 3-month program. audio stroop boy/girl audio stroop high/low audio stroop loud/soft audio stroop male/female words audio stroop whisper/shout blue & yellow stroop breath meditation buttons stroop color nonresponse directional flanker w/ switch directional stroop w/ switch double speak faces same/different finish the lyrics fish flanker high/low stroop inhibition flanker irregular shapes memory shapes number variation stroop order stories distractions pain visualization patterns on clock placement stroop pleasant experiences same/different colors same/different line directions semantic word stroop shape arrangements stroop shapes on clock stop signal task stop signal with switch stroop animals stroop color blocks stroop shapes to do or not to do triangle directional stroop word number stroop All games listed above currently have only paper & pencil versions where a person administers the game to the participant using visual and/or verbal content (depending on the nature of the game) and the participant responds verbally. Therefore, these games will need to be developed into automated electronic versions suitable to be played on a smartphone. The contractor under the guidance of the project coordinator will develop an appropriate design for each game to run on the smartphone. The goal is to develop a user-friendly solution for each game so that it functions similarly to the paper & pencil version. All game parameters and content (e.g., visual & verbal stimuli and acceptable user responses, timeouts) will be designed to be modifiable and loaded in at run-time so that changes can be made to these parameters and content without needing to change the code. Each game will be designed to have at least 2 different variations. [NOTE: for the paper & pencil versions, there are many games with only 1 variation and several games have more than 2 variations] The application will maintain an active set of different games (modifiable parameter, number to be loaded at run-time, default = 3) for the user to play during each session. For each of the active games in the set, the user will play a given number of variations (default = 2) of that game - this will be referred to as game activity. A game will be retired and replaced by a new game in the active set once all of the variations have been played. Each game activity will be designed to take just under three minutes to complete. The total number of game activities to be played during each session will be modifiable and set at run-time (default = 6) If the user has been assigned to receive both physical exercise and cognitive exercise in combination, the cognitive exercises will be delivered during the warm-up period and the five low-intensity periods of the physical exercise (see physical exercise application above). Each game will have a short detailed practice activity to provide the instructions to the user. A user must respond correctly during the practice to go on to the actual game activity. During a game activity, a monitoring function will be needed to assess the likelihood that a user does not fully understand the activity. If it is determined that the user may not understand, the current game activity will be stopped and the user will return to the practice activity to review the instructions again. All participant responses will be recorded with timestamps on the smartphone database. A total correct score will be calculated for each game activity. Common routines needed for both interventions Interactive counseling for both physical and cognitive interventions A routine will need to be developed to deliver a specific interactive counseling module to a user to choose an appropriate module based on data from the current session and previous sessions. Furthermore, the content within each module will be programmed to vary the dialogue that is provided to the user over time. The type of counseling delivered depends on several factors, such as adherence, number of incomplete sessions, and performance (i.e., HR levels, cognitive scores). Some examples of the types of counseling triggered based on session data are provided as follows. Counseling in the form of reinforcement is triggered when a participant 1) reaches or exceeds the target HR (see Table 1) during 3 or more high-intensity biking periods during a session, 2) scores a total of 80% or higher on the cognitive component of a session, or 3) performs all 3 sessions during a given week with no incomplete sessions. This reinforcement is provided to the participant in the form of praise for the particular accomplishment or a suggestion on how to appropriately reward oneself. Counseling in the form of self-efficacy is triggered when recent adherence is below 3 sessions per week or the current session is incomplete. This counseling is designed to promote self-efficacy by asking questions about the participant s motivation and confidence and delivering tailored messages to increase motivation and confidence. Counseling in the form of goal-setting is triggered when the participant does not achieve the minimum HR target (see Table 1) during a session. In this case, the participant is asked to set a goal to reach a specific HR for the next session by negotiating with the participant to choose a HR that is higher than the highest HR achieved during the current session. During the next session, the program reminds the participant of this goal. If the participant reaches the HR goal during the subsequent session, positive reinforcement is given, which may help to build self-efficacy. Data generated from the interactive counseling module will be saved, including which module is delivered along with participant responses. Scheduling and reminder routine The interventions will be scheduled to be done 3 days per week. At enrollment, users will indicate the 3 preferred days and times for sessions. This information will populate a default schedule for each week. The application will require users to schedule 3 sessions each week. Users will be able to view the schedule at any point and change scheduled days and times for upcoming sessions. Users will also be able to change their preferred days and times. A function will be required to assess and monitor the probability that the user will successfully complete 3 sessions in a given week (i.e., receive the proper dose) and then use this information to prompt the user to add more sessions as necessary. As each week progresses, this function will dynamically determine this probability accounting for past performance, incomplete and/or missed sessions during the current week, the current day of the week (e.g., day 1 vs. day 6 of the given week), and the user s preferred days. The delivery of alerts to prompt the user to begin or schedule a session will be directly related to the calculated probability as the probability goes down, the alerts will be escalated. The goal will always be to get the user to complete 3 sessions each week. At the conclusion of each session, the user will be given a choice to adjust the remaining scheduled days of the week if desired. An alert will be delivered on the smartphone at the scheduled time on the selected day that a session is due. This alert also will determine the power state of the device and set it to full power if needed. The user will be given a combined visual and audio reminder with a choice to begin the session, snooze the reminder alert, or reschedule the session to another day and time. If the user chooses to begin the session, the intervention session will be started. If the user is not ready, the application will negotiate a new starting time for the session (add 90 minutes by default) and the process is repeated. If there is no user reponse within 5 minutes of the alert, the alert will be snoozed for a specified number of minutes (default=90) and the process is repeated. All user responses from the reminder alerts (begin, snooze, or reschedule) and nonresponses will be saved in the database with current timestamp. The reminder alerts shall cease at 9pm. Data Recording and Transfer During each session, detailed data will be recorded and stored in the database of the smartphone. Once a session is completed, the application will compile, encrypt, and transmit the encrypted data to a specified email (modifiable parameter, loaded at run-time). Speech-enabled response module A speech-enabled module is needed to make user response hands-free. This module will incorporate user-independent speech recognition so that any question requiring a user response can allow for a spoken response in addition to the existing keypad or touchscreen input. This module will be created so that it can be embedded into and used by either the physical or cognitive exercise applications. Responses will utilize both pre-defined and customized grammar definitions. Delivery: Boston VA HCS 150 South Huntington Avenue Boston, MA 02130-4817 Installation: Installation and demonstration are required for this equipment. Information Technology: IT support requirements is required for this equipment. RESPONSE COMMITMENT - Response: - Capability statement and with general understanding of the industry and current knowledge and subcontract networks that would be used to support the requirement as identified herein. Provide small business information for your company. Submittals furnished will not be returned to the sender. No debriefs will be conducted. Eligibility in participating in a future acquisition does not depend upon a response to this notice. - Timeline: - This request will close on stated date within the Government Point of Entry (GPE). - Notes: - This Sources Sought is for planning purposes only to gain knowledge of potential qualified sources and their size classification (large business, small business, 8(a), SDVOSB, etc.), relative to NAICS code 518210. Responses to this source sought will be used by the Government to make appropriate acquisition decisions. This notice is not a request for competitive proposals; however, any responsible source who believes it is capable of meeting the requirement and who is the Original Equipment Manufacturer (OEM), authorized dealer, authorized distributor or authorized reseller of all the items listed above, may submit a capability statement to the contracting office than no later than Wednesday, June 29, 2023, 12:00 PM EST. Interest/capability statements may be sent to Matenoa Taufa contact@example.gov. No telephone responses will be accepted.